Dr. Gary Bloch on basic income and health through the mitigation of poverty

Roderick Benns recently interviewed Dr. Gary Bloch about basic income. Bloch is a family physician with St. Michael’s Hospital in Toronto, and co-Chair of the Ontario College of Family Physicians’ Committee on Poverty and Health. His clinical, educational, program development, and research interests focus on the intersection between poverty and health, and specifically on what primary care providers can do to address poverty as a health issue.

Benns: We’re set to introduce a pilot on basic income here in Ontario. Are you optimistic this multi-year project will lead to a full-fledged model for the province and a measurable increase in people’s health?

Bloch: I am cautiously optimistic. I think a pilot like this is a big investment, and wouldn’t be undertaken if there weren’t at least some intent to follow up on the findings longer term.

I am definitely optimistic that the pilot will find improvements in health, along with other markers of social and personal well-being. I am concerned that any reasonable broader scale-up is likely to happen after the next provincial election, which could easily leave the pilot orphaned under a new government that doesn’t feel invested in its outcomes. That said, there seems to be significant interest in Basic Income provincially, nationally, and internationally, and a pilot can only add fuel to the fire of interested politicians and advocates into the future. So at minimum this will help build the pressure.

Benns: How do you counter the ‘Protestant work ethic angle’ that we face here in Canada (and the US) about whether or not someone really ‘deserves’ a basic income?

Bloch: In my experience, having worked for over a decade as a family physician with some of the lowest income residents of Toronto, I have yet to meet those mythological beings who are happy to sit back and live comfortably on government assistance. Most people know that engaging in society, through employment and other means of social involvement, makes them happier and healthier. Those who have the most trouble finding and maintaining jobs often have very good reasons for doing so — caring for children or other family members, dealing with disabilities, histories of adverse life experiences, and more. Everyone has a story, and once we are willing to hear those stories, we quickly become disabused of the false stereotypes that underlie this misconception.

Benns: There are many people who work to mitigate poverty that say why not just top up our existing programs properly, since that infrastructure is already in place. Is this good enough?

Bloch: Canada is blessed, and cursed, with a dizzying, complex array of income support programs. A few people find an adequate social safety net in there, but far too many fall through the cracks or get lost in the rules and bureaucracy. I am involved with efforts in Ontario to improve the income security support structure in this province, and I am hopeful we will make some positive changes that will provide both a higher level of support, and a simpler system to navigate, but this will require a broad and sustained commitment by government to implementing these changes.

A basic income program may hold the potential to simplify and supersede at least some of the existing programs. That said, a basic income program could easily suffer from some of the same pitfalls as people face now, especially in providing an income that is inadequate to meet the needs of individuals and families. So, there may be other acceptable approaches to building a decent social safety net, but the idea of a basic income is attractive in that it could meet the goals of making income supports simple to access, portable, and (if it is structured appropriately) adequate to protect health and well-being; and it could do so without the stigmatizing and dehumanizing principles underlying our current system of social assistance.